NMAT IDENTIFICATION FORM

(Must be presented to the Examiner on the day of the test)

Bank Reference Number : 3441975692

NMAT Application Number : 1031203307

Name of Applicant : MARIAN KIMBERLY CLAIRE BAUTISTA MANIULIT

Mailing address : Blk 1 Lot 26 San Pedro Compound 5 Himlayan Rd, Tandang Sora, Quezon City,
Quezon City, Metro Manila (NCR) 1116 Philippines
Test Center : Manila

Test Date : 2012-03-25

Year & College Graduating/Graduated From : 2013, [University of the Philippines, Manila] Ermita, City of Manila, First District
FOR THE APPLICANT:
1. Please attach a recent 2" x 2" colored photo (with white background) on the box provided below.
For graduating students, please have your schoolhead affix his/her signature on the lower front portion of the picture.
For college graduates, please attach a photocopy of your official transcript of records (TOR) to be presented on the day of the
test. Signature of your schoolhead is required only if you cannot present a photocopy of your TOR.
2. Bring this Form to the nearest Bank of the Philippine Islands (BPI) branch and pay the NMAT Registration and Test Fees
(PhP1900.00 PHP) on or before March 02, 2012.
Copy exactly the Bank Reference Number found on top of this Form and CEM's BPI account number 1881-0450-24 on
the BPI Payment/Deposit Slip.
3. You must download and print ALL attachments which are the NMAT Identification Form and other information in the
application form and verify if all the information given in the form are true and correct.
FOR THE SCHOOL HEAD:
Please affix your signature on the
lower front portion extending beyond
the edges of the applicant's picture
and on the space provided below to
attest to the fact that the person getting
your signature is the same person who
will take the NMAT.

Attach a 2" x 2"

colored photo here

FOR THE EXAMINER:

Please verify that the person
presenting this Form is the same as the
one in the picture and in the valid ID
he/she will present.

I hereby certify that the person in the above picture is one and the same as the NMAT applicant who is graduating/has graduated
from this institution on the date specified above and whose signature appears below.

Printed Name of School Head

Designation of School Head

1031203307

Signature of Applicant

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FORM NMAT-ONLINE-BOI-0002